[Malignoma versus bacterial spondylodiscitis: value of spinal MRI for the differential diagnosis in an emergency situation. Description in an acute case with progressive paraplegia].
BACKGROUND
For the radiation oncologist in an emergency situation with acute progressive paraplegia distinguishing between benign versus malignant vertebral compression fracture without known malignoma may cause a severe diagnostic problem, when a rapid therapeutic decision is required.


METHODS
A case of an elderly diabetic patient with acute onset of a progressive neurologic deficit is reported. No malignancy was known so far. The CT of the spine showed a destruction of the 7th and 8th thoracic vertebral body with compression of the spinal cord. The patient was referred to the radiotherapist for radiation of a presumed malignant spinal process.


RESULTS
For differential diagnosis a magnetic resonance imaging (MRI) of the spine was performed and could lead to the correct diagnosis of an infectious spondylodiscitis.


CONCLUSIONS
The MRI of the spine has a potential role for correct differentiation between benign and malignant spinal lesions and may thereby assist the radiotherapist in the decision making in an emergency situation.
Bremer
M
M
Abteilung für Strahlentherapie und spezielle Onkologie, Medizinische Hochschule Hannover.
Herzog
T
T
Karstens
J H
JH
D000368:Aged; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003929:Diabetic Neuropathies / Q000150:complications*; D003937:Diagnosis, Differential; D004630:Emergencies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010264:Paraplegia / Q000150:complications*; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis*; D013128:Spinal Osteophytosis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed
Malignom versus bakterielle Spondylodiszitis: Bedeutung der spinalen MRT für die Differentialdiagnose in der Notfallsituation. Beschreibung einer akuten Querschnittssymptomatik.